Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H1155

Introduced
2/27/25  

Caption

Empowering health care consumers

Impact

The implications of HB 1155 are significant, as it sets a legal framework for health plans to follow, promoting greater accountability and consumer awareness. By requiring the disclosure of formulary information, the bill is expected to affect the way enrollees make informed choices about their healthcare options, potentially leading to better health outcomes and satisfaction among consumers. Additionally, it may incentivize health plans to offer more competitive pricing and coverage options, fostering a more consumer-centric healthcare environment in Massachusetts.

Summary

House Bill 1155, known as 'An Act empowering health care consumers', aims to enhance the transparency and accessibility of prescription drug formularies provided by health plans in Massachusetts. The bill mandates that any health insurance policy or agreement issued or renewed post-January 1, 2018, must notify enrollees if a formulary is in use. Furthermore, it outlines requirements for making this information accessible, such as posting the formulary details online and updating any changes within a 72-hour timeframe. Overall, the bill seeks to empower consumers by ensuring they have clear and timely information about the drugs covered and the costs involved.

Contention

While supporters of the bill argue that it is a necessary step towards consumer empowerment in healthcare, there may be points of contention regarding the administrative implications for health plans. Critics might raise concerns about the complexity of implementing the requirements for formulary disclosures and the potential for increased operational costs. Some stakeholders could also argue that it may create confusion among enrollees regarding tiered medication coverage and cost-sharing structures, which need careful management to ensure clarity.

Companion Bills

No companion bills found.

Previously Filed As

MA H151

Relative to cannabis research

MA H570

Relative to testing requirements for veterans who wish to become educators

MA H366

Relative to preventing illegal alcohol sales

MA H2101

To enforce laws protecting worksite safety

MA H3957

Establishing a fund for the Western Massachusetts Hospital

MA H2826

Relative to impairment of health caused by infectious disease

MA H364

Relative to the collection of debt

MA H2102

Relative to acts of violence

Similar Bills

MA S694

Empowering health care consumers

AZ SB1102

Pharmacy benefits; prescribing; exemption

MD SB393

Health Insurance - Prescription Drug Formularies and Coverage for Generic Drugs and Biosimilars

MN SF1806

Certain formulary changes during the plan year prohibition provision and medical assistance program formulary changes implementation for certain enrollees prohibition provision

ME LD1128

An Act to Modernize the Formulary for Naturopathic Doctors

VA HB2329

Health insurance; prescription drug formularies.

MN SF2645

Formulary Committee members with a potential conflict of interest participation in committee communications and discussions authorization provision, public comment process for recommendations to the Formulary Committee development by the commissioner of human services requirement provision, and Minnesota Rare Disease Advisory Council expertise sought by the Formulary Committee requirement provision

TX SB895

Relating to the transparency of certain information related to prescription drug coverage provided by certain health benefit plans.